US20040015174A1 - Guide assembly for engaging a bone plate to a bony segment - Google Patents
Guide assembly for engaging a bone plate to a bony segment Download PDFInfo
- Publication number
- US20040015174A1 US20040015174A1 US10/200,397 US20039702A US2004015174A1 US 20040015174 A1 US20040015174 A1 US 20040015174A1 US 20039702 A US20039702 A US 20039702A US 2004015174 A1 US2004015174 A1 US 2004015174A1
- Authority
- US
- United States
- Prior art keywords
- guide
- bone plate
- assembly
- guide assembly
- fastener
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1735—Guides or aligning means for drills, mills, pins or wires for rasps or chisels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
Abstract
Description
- The use of bone plates for a variety of orthopedic applications is widely practiced. The plates are used to align, mend, and/or alter adjacent bony segments in a patient using a plurality of fasteners such as screws installed through openings in the plate. Correct orientation and alignment of fasteners can be important to proper engagement and positioning of the bone plate relative to the bony segment to which it is engaged.
- Bone plates used in spinal applications can be particularly sensitive to positioning and engagement to bony segments of the spinal column. Spinal bone plates can be used for long term, intravertebral and intervertebral fixation and stabilization. Because of the spinal cord and other sensitive anatomical structures adjacent the spinal column, and the relatively small size of the vertebral areas, the desired areas of positioning and alignment of bone engaging fasteners to secure the bone plate to the particular bony segment of the spinal column can be relatively small. A guide assembly capable of maintaining alignment of surgical instruments with respect to a bone plate during engagement of the bone plate to a bony segment is desired.
- The present invention relates to a guide assembly positionable relative to bone plate to provide an alignment therebetween for the positioning and engagement of bone engaging fasteners through holes in the bone plate.
- According to one aspect of the invention, there is provided a guide assembly for a bone plate. The guide assembly includes at least one guide member alignable with a fastener hole of the bone plate and a handle extending proximally from the guide member. A base is adapted to support the guide member on the bone plate. The base has a foot member engageable with the bone plate and a biasing member contactable with the bone plate to bias the base proximally from the bone plate.
- According to another aspect of the invention, there is provided a guide assembly for a bone plate. The guide assembly includes at least one guide member and a handle extending proximally from the at least one guide member. A base positionable relative to the bone plate supports the at least one guide member in alignment with a fastener hole of the bone plate. The base includes a first member contactable with a distal surface of the bone plate and a second member contactable with one of a proximal surface of the bone plate and bony structure underlying the bone plate to secure the at least one guide member in alignment with the fastener hole of the plate.
- According to a further aspect of the invention, there is provided a system that includes a bone plate and a guide assembly. The bone plate includes a receptacle and at least one hole for a bone engaging fastener. The guide assembly includes a handle and a guide member extending from the handle that is alignable with the at least one hole of the bone plate. The guide assembly also includes a base extending from the guide member. The base includes a first member positioned in the receptacle and a second member distally biased toward the bone plate.
- According to another aspect of the invention, a system is provided that includes a bone plate and a guide assembly. The bone plate includes a receptacle and at least one hole for a bone engaging fastener. The guide assembly includes a handle and a guide member extending from the handle alignable with the at least one hole. The guide member includes a distal end spaced from a proximal surface of the bone plate. The guide assembly further includes a base positionable in the receptacle. The base includes a member in contact with the bone plate that has a variable length so that the guide member can assume any one of a plurality of positions relative to the bone plate.
- According to a further aspect of the invention, a guide assembly for a bone plate is provided. The guide assembly includes at least one guide member alignable with a fastener hole of the plate and a handle extending from the at least one guide member. The guide assembly further includes means for supporting the at least one guide member relative to the bone plate with the at least one guide member aligned with the fastener hole. The means for supporting includes means for biasing the means for supporting proximally relative to the plate.
- According to another aspect of the invention, there is provided a method for positioning a guide assembly relative to a bone plate having at least one fastener hole and a receptacle. The method includes sliding a foot member of guide assembly into a receptacle in the bone plate; and biasing the guide assembly proximally relative the bone plate to secure the foot member in the receptacle.
- These and other aspects of the invention will also be provided in the following description.
- FIG. 1 is a side view of a guide assembly for guiding instruments to secure a bone plate to a bony segment according to the invention.
- FIG. 2 is a front view of the guide assembly of FIG. 1.
- FIG. 3 is a side view of the guide assembly of FIG. 1 with a drill guide.
- FIG. 4 is a front view of the guide assembly and drill guide of FIG. 3.
- FIG. 5 is a perspective view of one embodiment of a bone plate having application with the guide assembly of FIG. 1.
- FIG. 6 is a side view of the guide assembly of FIG. 1 positioned on the bone plate of FIG. 5.
- FIG. 7 is a front view of the guide assembly and bone plate of FIG. 5 with one embodiment of a guide positioned in the guide assembly.
- FIG. 8 is a front view of the guide assembly positioned on the bone plate a guide positioned in the guide assembly.
- FIG. 9 is a partial cross-sectional view, to a larger scale, of a portion of the bone plate of FIG. 5 with the guide assembly positioned thereon.
- FIG. 10 is a partial cross-sectional view, to a larger scale, of a portion of the bone plate with the guide assembly positioned thereon.
- For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended. Any alterations and modifications in the illustrated devices and methods, and any further applications of the principles of the invention as illustrated herein, are contemplated as would normally occur to one skilled in the art to which the invention relates.
- Referring to FIGS. 1 and 2, there is shown one embodiment of a guide assembly adapted for use with a bone plate having one or more fastener openings.
Guide assembly 10 includes one or more guide members alignable with fastener openings of the bone plate to guide drilling, tapping, and/or fastener placement through the aligned fastener hole of the plate. -
Guide assembly 10 includes ahandle assembly 14 including ahandle 15 and ashaft 20 extending distally fromhandle 15. Adistal guide portion 12 extends distally fromshaft 20. In one embodiment,handle assembly 14 can be rotated relative toguide portion 12 about acoupling assembly 25. In another embodiment,handle assembly 14 can be fixed and/or non-rotatable relative toguide portion 12. - In the illustrated embodiment of the
rotatable handle assembly 14,shaft 20 includesdistal pin 27 extending through and rotatably received in a central passage extending through acoupling member 29. Aspring 28 extends betweencoupling member 29 and a head ofpin 27 to biasshaft 20 distally into contact withcoupling member 29. To fixshaft 20 relative tocoupling member 29,shaft 20 includes alocking member 26 extending laterally therefrom received in certain ones ofnotches 23 positioned about a proximal end ofcoupling member 29. - In the illustrated embodiment,
locking member 26 is received innotches 23 so thathandle 15 extends away fromguide portion 12.Handle assembly 14 could be repositioned relative toguide portion 12 by liftinghandle 15 to compressbiasing member 28 betweencoupling member 29 and the head ofpin 27 sufficiently to removelocking member 26 fromnotches 23.Shaft 20 can be rotated 90 degrees in either direction incoupling member 29 toreposition locking member 26 in another notch, such as thenotch 23 shown in FIG. 2, wherehandle 15 would extend laterally fromguide portion 12. It is also contemplated thatshaft 20 include a second locking member extending therefrom opposite the illustratedlocking member 26 to position the second locking member in the opposite notch and provide solid engagement betweenhandle assembly 14 andguide portion 12. - It is contemplated that four
notches 23 could be provided and spaced at 90 degree intervals aboutcoupling member 29. Other embodiments contemplateadditional notches 23 at other locations to provide other orientations betweenhandle assembly 14 andguide portion 12. Handleassembly 14 could also be rotated so thatshaft 20 and handle 15 extend acrossguide portion 25. - Coupling
assembly 25 further includes a pair of guidemember receiving portions member 29. Guidemember receiving portions guide members guide portion 12 therethrough. In one embodiment, guidemembers proximal end 34 and adistal end 32 ofguide member 30 and at aproximal end 36 and adistal end 33 ofguide member 31. Other arrangements forguide members assembly 10 is positioned. It is further contemplated thatguide assembly 10 could be provided with a single guide member, or with more than two guide members. - In order to support
guide assembly 10 on a bone plate, there is provided a base 35 that is positionable with respect to a bone plate to secureguide assembly 10 thereto withguide members Base 35 includes afirst member 40 and asecond member 45 contactable with one or both of the plate and the bony structure underlying the plate to secureguide assembly 10 to the plate. - In one embodiment,
base 35 includes asupport member 41 extending between a distal end and a proximal end thereof.First member 40 is positioned at the distal end ofsupport member 41 and anextension 44 is positioned at a proximal end ofsupport member 41.Base 35 further includes a guidemember engagement portion 49 extending from the proximal end thereofopposite extension 44. Guidemember engagement portion 49 can be engaged to guidemembers guide members assembly 14 tobase 35. In the illustrated embodiment, guidemember engagement portion 49 extends betweenguide members Guide members engagement portion 49 by welding, bolting, riveting, screwing, adhering or otherwise attachingguide members - In the illustrated embodiment,
first member 40 is a foot member extending laterally fromsupport member 41, and includes anupper portion 42 and alower portion 43 defining a space therebetween.Upper portion 42 extends transversely to supportmember 41 in a first direction, andlower portion 43 extends from an end ofupper portion 42 back towardsupport member 41. Thus, in the illustrated embodiment, the foot member forms a hook-like shape that, as discussed further below, is positionable in a receptacle of the bone plate. Other embodiments contemplate other arrangements forfirst member 40, such as a threaded shaft or pin, a radially expandable collet, or a configuration that grasps the sides of the bone plate, for example. - In the illustrated embodiment,
second member 45 includes apin 47 movably received in a passage throughextension 44. Aspring 51 extends betweenextension 44 and aplate 46 extending about and fixed to pin 47. As indicated byarrows 102, (FIGS. 9 and 10),spring 51 biases adistal end 50 ofpin 47 distally, yet allowspin 47 to move proximally relative toextension 44 in response to a force applied proximally todistal end 50. Other embodiments contemplate other arrangements forsecond member 45, such as a threaded shaft or pin, a radially expandable collet, or a configuration that grasps the sides of the bone plate, for example. - With reference to FIGS. 2 and 4, one contemplated arrangement for
guide assembly 10 includes a pair ofguide members Guide members guide members Guide members longitudinal axes axes longitudinal axes angle 55 of about 12°. Other embodiments contemplate other convergence angles 55 forlongitudinal axes axes - As shown in FIGS. 3 and 4, guide
members instrument guide 60 can be inserted throughguide member 30.Instrument guide 60 includes adistal end 62 positioned distally ofdistal end 32 ofguide member 30, and aproximal handle portion 64 that extends proximally ofproximal end 34.Instrument guide 60 can include amain body 61 removably received in form fitting engagement withguide member 30 so thatguide member 30 alignsinstrument guide 60 along itslongitudinal axis 95. Acollar 63 can extend radially aboutmain body 61 and handleportion 64 to abut the proximal end ofguide member 30 and/or guidemember receiving portion 37. - A drill bit, for example, can be inserted in instrument guide60 to form a hole in the bony structure underlying the plate upon which guide
assembly 10 is positioned. It is also contemplated thatguide members guide members 30, 3 1. - In one embodiment, guide
assembly 10 is adapted for engagement with abone plate 65 as shown in FIG. 5.Bone plate 65 is one, non-limiting example of a type of bone plate suitable for use with the present invention. Other suitable bone plates may also be used.Bone plate 65 includes aproximal face 67 and adistal face 69, can be provided with a number offastener openings 70 extending therebetween. Acentral aperture 80 can also provided inbone plate 65.Bone plate 65 can also includerecesses 82 formed inproximal surface 67 in communication with respective pairs of the fastener holes 70. Each of therecesses 82 can be provided with a retainingelement 75 slidably captured therein. Retainingmembers 75 each include aproximal face 77 and adistal face 79. After bone engaging fasteners, such asbone screw 71, are positioned in respective ones ofholes 70, each retainingelement 75 is movable in itsrecess 82 so thatprotrusions 84 contact or extend over at least a portion of respective ones of the heads of the bone engaging fasteners to prevent the bone engaging fasteners from backing out relative to plate 65. - FIGS. 6 and 7 illustrate
guide assembly 10 positioned onbone plate 65.Base 35 ofguide assembly 10 engagesbone plate 65 withfirst member 40 andsecond member 45. Whenguide assembly 10 is positioned onbone plate 65, the distal ends 32, 33 ofguide members proximal surface 67 ofbone plate 65 so as to not obstruct theadjacent fastener hole 70. This preventsguide members guide members guide members guide members - As shown FIG. 7, another
embodiment instrument guide 85 is positioned in and supported onguide member 30.Instrument guide 85 does not engage thebone plate 65 when used but rather is supported by itscollar 86 on the proximal end ofguide member 30 and/or guidemember receiving portion 37 such that its distal end is spaced fromproximal surface 67 ofbone plate 70. - As shown in FIG. 8, a
fastener driver 90 is positioned inguide member 30 and has adistal end 94 that engagesbone engaging fastener 71 to insertfastener 71 in therespective plate hole 70.Fastener driver 90 can include amain body portion 92 received in form fitting engagement inguide member 30 to guidefastener 70 relative thereto. Aproximal end 91 can be engaged by a manual or power tool to rotatedriver 90.Fastener 71 can be inserted after drilling a hole into the bonystructure underlying plate 65 with, for example,instrument guide 60. If desired, a tapping guide and tap can be inserted throughguide member 30 to tap the previously drilled hole. The drilling and, if desired, tapping and fastener insertion could then be repeated throughguide member 31 for another plate hole aligned therewith. It is also contemplated that self-tapping fasteners could be employed, and inserted and guided into the drilled hole withguide members guide members - Further details regarding the interface of one
embodiment guide assembly 10 andbone plate 65 are shown in FIG. 9. FIG. 9 shows a partial cross-sectional view ofbone plate 65 along one of the retainingmembers 75.First member 40 is engageable to retainingmember 75 andsecond member 45 is positioned in alignment withaperture 80.First member 40 is positioned inrecess 82 such thatlower portion 43 of the foot member slides in a receptacle betweendistal surface 79 of retainingmember 75 and aproximal surface 87 ofbone plate 65.Upper portion 42 extends proximally of retainingmember 75.Second member 45 is positioned inaperture 80 such thatdistal end 50 contacts thebony structure 100underlying plate 65. It is also contemplated that, as shown in FIG. 10,distal end 50 can contactproximal surface 67 ofplate 65, or any other proximally facing or generally proximally facing surface ofplate 65. - As
distal end 50 is positioned in contact with the bony structure,spring member 51 biases supportmember 41 proximally and thuslower portion 43 into contact withdistal surface 79 of retainingmember 75. This provides an interference pressure fit betweenfirst member 40 and retainingmember 75 to secureguide assembly 10 toplate 65. To removeguide assembly 10, the handle can be used to movedistal end 50 out of contact withbony structure 100 so thatspring member 51 is uncompressed, andfirst member 40 can slide out from between retainingmember 75 andplate 65. - Furthermore, since
pin 47 can move relative to supportmember 41 in the directions indicated byarrow 102, the orientation ofguide members second member 45 has a length betweenextension 44 and itsdistal end 50 that can vary asspring member 51 is moved between varying states of compression. - As shown in FIG. 10, in one
embodiment retaining member 75 can be provided with aprotrusion 78 extending fromdistal surface 79 thereof.Protrusion 79 can engage a detent (not shown) inplate 65 to prevent retainingmember 75 from moving relative thereto whenprotrusions 84 are engaged to or extend over the bone engaging fasteners in the plate. To accommodateprotrusion 78 upon the insertion oflower portion 43 betweensurfaces lower portion 43 to be full inserted in the receptacle therebetween, anotch 53 can be proved in the leading insertion end oflower portion 43. Positioning ofprotrusion 78 innotch 53 can also prevent retainingmember 75 from sliding relative to plate 65 during fastener insertion. - Although
plate 65 has been shown with a receptacle that includes retainingmember 75 slidably captured therein, other receptacle forms are contemplated. For example, the receptacle could be any opening in the plate that allowslower portion 43 of the foot member to contact a distally oriented surface. Other embodiments contemplate a threaded receptacle or opening suitably configured for engagement withfirst member 40. - While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character. All changes and modifications that come within the spirit of the invention are desired to be protected.
Claims (40)
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
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US10/200,397 US7011665B2 (en) | 2002-07-22 | 2002-07-22 | Guide assembly for engaging a bone plate to a bony segment |
PCT/US2003/022293 WO2004008972A2 (en) | 2002-07-22 | 2003-07-17 | Guide assembly for engaging a bone plate to a bony segment |
AU2003259144A AU2003259144A1 (en) | 2002-07-22 | 2003-07-17 | Guide assembly for engaging a bone plate to a bony segment |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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US10/200,397 US7011665B2 (en) | 2002-07-22 | 2002-07-22 | Guide assembly for engaging a bone plate to a bony segment |
Publications (2)
Publication Number | Publication Date |
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US20040015174A1 true US20040015174A1 (en) | 2004-01-22 |
US7011665B2 US7011665B2 (en) | 2006-03-14 |
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US10/200,397 Expired - Lifetime US7011665B2 (en) | 2002-07-22 | 2002-07-22 | Guide assembly for engaging a bone plate to a bony segment |
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US (1) | US7011665B2 (en) |
AU (1) | AU2003259144A1 (en) |
WO (1) | WO2004008972A2 (en) |
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Also Published As
Publication number | Publication date |
---|---|
US7011665B2 (en) | 2006-03-14 |
AU2003259144A8 (en) | 2004-02-09 |
AU2003259144A1 (en) | 2004-02-09 |
WO2004008972A3 (en) | 2004-05-21 |
WO2004008972A2 (en) | 2004-01-29 |
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